Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study

Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients ( n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers ( n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26–0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93–0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03–2.48). Healers (AOR = 1.16, 95% CI 1.07–1.26) and clients (AOR = 1.28, 95% CI 1.13–1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.

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Relationship between gay app use and HIV testing among men who have sex with men in Shenzhen, China: a serial cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-028933 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028933

Author(s):

Lan Wei ◽

Lin Chen ◽

Haibo Zhang ◽

Zhengrong Yang ◽

Shaochu Liu ◽

...

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Hiv Test ◽

Related Service ◽

Sex With Men ◽

Group Sex ◽

High Level

ObjectivesTo investigate the relationship between gay app use and HIV testing among men who have sex with men (MSM).DesignSerial cross-sectional study.SettingA newly well-developed city in China.Participants4935 MSM were recruited through offline sampling methods from 2015 to 2017.Primary and secondary outcomesThe primary outcome is the difference in HIV testing between app and non-app users.Results2872 (58.2%) and 2159 (43.7%) participated MSM had been tested for HIV within lifetime and the past year, respectively. Compared with non-app-using MSM, app-using MSM had a significantly higher prevalence of HIV testing within lifetime (adjusted OR (AOR): 1.48, 95% CI 1.27 to 1.72) and the past year (AOR: 1.36, 95% CI 1.18 to 1.57). App-using MSM were more likely to take an HIV test at the Centers for Disease Control and Prevention (AOR: 1.48, 95% CI 1.24 to 1.76) and community-based organisations (AOR: 1.71, 95% CI 1.44 to 2.03), but less often at gay venues (AOR: 0.49, 95% CI 0.37 to 0.63). Meanwhile, app-using MSM were more likely to take self-testing (AOR: 1.61, 95% CI 1.21 to 2.14). Predictors of HIV testing in the past year were: having an education level of college or higher (AOR: 1.29, 95% CI 1.01 to 1.65), being self-identified as a homosexual (AOR: 1.23, 95% CI 1.02 to 1.46), being recruited through clinic-based sampling (AOR: 1.30, 95% CI 1.06 to 1.60), using gay app (AOR: 1.49, 95% CI 1.21 to 1.83), engaging in group sex (AOR: 1.64, 95% CI 1.23 to 2.19), having received HIV-related service (AOR: 5.49, 95% CI 4.57 to 6.60), having a high level of HIV-related knowledge (AOR: 1.33, 95% CI 1.10 to 1.61) and high-risk perception (AOR: 2.95, 95% CI 1.40 to 6.23).ConclusionsGay app use was significantly associated with increased HIV testing among MSM hard to reach by traditional outreach. Therefore, it is imperative to expand HIV testing among non-app-using MSM. Continued efforts, innovative strategies and increased resource are highly needed to realise the first ‘90’ target.

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Recent HIV testing and associated factors among people who use drugs in Cambodia: a national cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-045282 ◽

2021 ◽

Vol 11 (3) ◽

pp. e045282

Author(s):

Chee Wen Eng ◽

Sovannary Tuot ◽

Navy Chann ◽

Pheak Chhoun ◽

Phalkun Mun ◽

...

Keyword(s):

Hiv Testing ◽

Illicit Drugs ◽

Cross Sectional Study ◽

Multivariable Logistic Regression Analysis ◽

People Who Use Drugs ◽

Hiv Education ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Hiv Test

ObjectiveTo estimate the prevalence of HIV testing and examine factors associated with recent HIV testing among people who use drugs (PWUD) in Cambodia.DesignCross-sectional study.SettingTwelve major provinces with a high burden of HIV and drug use in Cambodia.ParticipantsThis study included 1677 PWUD recruited using a peer-based social network recruitment method. Participants’ selection criteria included being at least 18 years old and using any illicit drugs via any administration routes in the past 12 months.Primary outcome measureRecent HIV testing, defined as having an HIV test in the past 6 months.ResultsThe median age of the participants was 28 (IQR 22–34) years, and 56.6% were men. The prevalence of lifetime and recent HIV testing was 70.7% and 42.9%, respectively. After adjustment in multivariable logistic regression analysis, recent HIV testing remained positively associated with being female (adjusted OR (AOR) 1.55, 95% CI 1.18 to 2.04) or third gender identity (AOR 2.06, 95% CI 1.11 to 3.80), having ever been to a drug rehabilitation centre (AOR 1.60, 95% CI 1.13 to 2.29), having used any HIV services in the past 6 months (AOR 7.37, 95% CI 5.61 to 9.69), having received HIV education in the past 3 months (AOR 3.40, 95% CI 2.63 to 4.40) and having self-perception of higher HIV risk (AOR 1.81, 95% CI 1.19 to 2.73).ConclusionsRecent HIV test uptake among PWUD in Cambodia was suboptimal. This study highlights the roles of outreach HIV education and services in promoting regular HIV testing among PWUD. Strengthening the coordinated effort of government agencies and local civil society organisations to prioritise expanding community-based peer-driven interventions to reach out to this hidden population is warranted.

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Uptake and Correlates of Chlamydia and Gonorrhea Testing among Female Sex Workers in Southern China: A Cross-sectional Study

10.21203/rs.3.rs-55555/v1 ◽

2020 ◽

Author(s):

Peizhen Zhao ◽

Ya-Jie Wang ◽

Huan-Huan Cheng ◽

Ye Zhang ◽

Wei-Ming Tang ◽

...

Keyword(s):

Hiv Testing ◽

Sex Workers ◽

Female Sex Workers ◽

Southern China ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Syphilis Testing ◽

Testing Uptake

Abstract Background: Female sex workers (FSW) are at high risk of chlamydia and gonorrhea infection. However, there is a limited literature examining their testing uptake to date. The aim of this study was to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China.Methods: A cross-sectional study with convenience sampling was conducted in five cities in Southern China. We collected data on socio-demographic characteristics, sex behaviors, chlamydia and gonorrhea testing in the past twelve months and the utilization of health care services from participants through face-to-face interviews. Multivariable logistic regression was performed to identify factors associated with chlamydia and gonorrhea testing, respectively.Results: Overall, 1207 FSWs were recruited, with the mean age of 30.7±6.8 years old, and an average number of clients per week of 7.0(4.0-10.0). 65.4% participants consistently used condoms with clients in the past month. Only 7.5% and 10.4% had been tested for chlamydia and gonorrhea in the past twelve months, respectively. Multivariable analysis indicated that FSW who worked at low titers (adjusted Odds Ratio (aOR)=2.36, 95%CI:1.23-10.14), had more clients in past month (aOR=1.03, 95%CI:1.01-1.05), used condoms consistently (aOR=1.79, 95%CI:1.12-2.86), had STD symptoms (aOR=4.09,95%CI:2.62-6.40), had HIV testing (aOR=5.16, 95%CI:3.21-8.30) or syphilis testing (aOR=6.90, 95%CI:4.21-11.22) in the past year were more likely to have received chlamydia testing. In addition, FSW who had more clients in the past month (aOR=1.02,95%CI:1.00-1.04), had STD symptoms (aOR=3.33, 95%CI:2.03-5.46), had HIV (aOR=3.94, 95%CI:2.34-6.65) and syphilis testing (aOR=3.27, 95%CI:1.96-5.46) in the past year were more likely to have gonorrhea testing.Conclusions: The chlamydia and gonorrhea testing uptake are low among Chinese FSW. Integrating chlamydia and gonorrhea testing promotion strategies into HIV testing promotion programs may help bridge the gap among FSW.

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Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041503 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041503

Author(s):

Peizhen Zhao ◽

Weiming Tang ◽

Huanhuan Cheng ◽

Shujie Huang ◽

Heping Zheng ◽

...

Keyword(s):

Condom Use ◽

Hiv Testing ◽

Transmitted Disease ◽

Cross Sectional Study ◽

Health Priorities ◽

Consistent Condom ◽

Sectional Study ◽

Cross Sectional ◽

Syphilis Testing ◽

Testing Uptake

ObjectivesUnderscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider’s ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China.DesignA cross-sectional study was performed between July 2016 and December 2016.SettingSeven STD clinics in Guangdong Province, China.ParticipantsHeterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing.Outcome measuresThe syphilis and HIV testing uptake determined by patient receipt of results.ResultsA total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake.ConclusionsThe low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.

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Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

10.21203/rs.3.rs-76060/v1 ◽

2020 ◽

Author(s):

Hang Hong ◽

Hong-bo Shi ◽

Hai-bo Jiang ◽

Hong-jun Dong ◽

Yun-liang Shen

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Sexual Contact ◽

Categorical Variables ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

The Past ◽

Self Testing ◽

Sex With Men

Abstract BackgroundHIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is an useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. MethodsA cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multiple logistic regression models.ResultsAmong a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST Users had a higher frequency of HIV testing(≥2 times: 70.0% versus 41.2%, p<0.001) in the past one year. Factor associated with HIVST uptake was gay apps use(AOR=1.86,CI=1.13-3.05), multiple male sex partners (AOR=1.90,CI=1.29-2.80), frequency of male-male sexual contact ≥1 times per week(AOR=1.86, CI=1.30-2.66), syphilis infection(AOR=5.48, CI=2.53-11.88).ConclusionsFurther HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to low-income high-risk MSM through gay apps and NGOs to achieve the increased HIV testing frequency.

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Prevalence and associated factors of HIV self-testing among men who have sex with men in Ningbo, China: a cross-sectional study

AIDS Research and Therapy ◽

10.1186/s12981-021-00339-x ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Hang Hong ◽

Hong-bo Shi ◽

Hai-bo Jiang ◽

Hong-jun Dong ◽

Yun-liang Shen

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Sexual Contact ◽

Categorical Variables ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Self Testing ◽

Test Kit ◽

Sex With Men

Abstract Background HIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is a useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. Methods A cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multivariable logistic regression models. Results Among a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST users had a higher frequency of HIV testing (≥ 2 times: 70.0% versus 41.2%, p < 0.001) in the past 1 year. The odds of older age (30–39 years: AOR = 0.49, CI 0.32–0.76; more than 40 years: AOR = 0.07, CI 0.04–0.14, compared to 18–29 years), bisexual (AOR = 0.49, CI 0.29–0.84) were lower among HIVST users,and were higher among MSM who were higher education level (high school: AOR = 2.82, CI 1.70–4.69, compared to middle school or less), gay apps use (AOR = 1.86, CI 1.13–3.05), multiple male sex partners (AOR = 1.90, CI 1.29–2.80), frequency of male–male sexual contact ≥ 1 times per week (AOR = 1.86, CI 1.30–2.66), syphilis infection (AOR = 5.48, CI 2.53–11.88). Conclusions Further HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to high-risk MSM through gay apps and CBO to achieve the increased HIV testing frequency.

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A Cross-Sectional Study Comparing Two Opt-Out HIV Testing Strategies in the Out-Patient Setting

Frontiers in Public Health ◽

10.3389/fpubh.2021.664494 ◽

2021 ◽

Vol 9 ◽

Author(s):

Greta Tam ◽

Samuel Yeung Shan Wong

Keyword(s):

Primary Care ◽

Hiv Testing ◽

Care Setting ◽

Hiv Infections ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Testing Strategies ◽

Opt Out ◽

Hiv Test

Background: HIV infections are generally asymptomatic, leading to undetected infections and late-stage diagnoses. There are a lack of acceptable testing strategies for routine opt-out HIV screening. Our aim was to evaluate and compare the diagnostic yield of routine opt-out HIV testing strategies in two out-patient settings in a low HIV prevalence country: The public primary care and specialist out-patient care settingMethods: A cross-sectional study was conducted in a primary care clinic over a four-week period in 2016 to 2017 and in a specialist out-patient clinic over a concurrent 11-month period. Patients were invited to complete a questionnaire assessing demographic characteristics, acceptance of opt-out HIV testing as a policy in all out-patient clinics in Hong Kong and reasons if refusing the HIV test. All respondents were offered an HIV test.Results: This study included 648 and 1,603 patients in the primary care and specialist out-patient clinic, respectively. Test acceptability was 86 and 87% in the primary care and specialist out-patient setting, respectively. Test uptake was 35 and 68% in the primary care and specialist out-patient setting, respectively. No HIV infections were detected.Conclusion: Opt-out HIV testing during routine blood taking in the specialist out-patient setting achieved a high test uptake and acceptability. In contrast, opt-out HIV testing using rapid finger-prick tests in the primary care setting was not effective.

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HIV testing uptake and prevalence among hospitalized older adults in Togo: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0246151 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246151

Author(s):

Fifonsi Adjidossi Gbeasor-Komlanvi ◽

Wendpouire Ida Carine Zida-Compaore ◽

Arnold Junior Sadio ◽

Martin Kouame Tchankoni ◽

Balakiyem Magnim Kadangha ◽

...

Keyword(s):

Older Adults ◽

Hiv Infection ◽

Hiv Testing ◽

Cross Sectional Study ◽

Hiv Positive ◽

Newly Diagnosed ◽

Sectional Study ◽

Cross Sectional ◽

Testing Uptake ◽

Hospitalized Older Adults

Objectives This study aimed to describe HIV testing uptake, as well as HIV prevalence and its associated factors among older adults aged ≥50 years in health facilities in Togo. Methods A cross-sectional study was carried out from February 2018 to June 2019 among hospitalized older adults aged ≥50 years in tertiary and secondary hospitals in Togo. HIV testing was performed according to the national algorithm. Socio-demographic data and HIV testing history were collected using a standardized questionnaire. Results A total of 619 patients (43.9% female) of median age 61 years, (IQR: 55–70) were recruited and offered HIV testing. Among them, 25.7% had never previously tested for HIV. In total, 91.6% (567/619) accepted HIV testing while 8.4% (52/619) refused to be tested. Of those who tested, forty patients were HIV positive, yielding a prevalence of 7.1%. Twenty-three patients (57.5%) were newly diagnosed with HIV infection. In multivariable analysis, two factors were associated with HIV infection: living alone (aOR = 5.83; 95%CI = [2.26–14.53]) and being <60 years (aOR = 3.12; 95%CI = [1.51–6.66]). Conclusion The majority of older adults in this study accepted testing for HIV and almost three in five HIV positive older adults were newly diagnosed with HIV as a result of this testing. There is an urgent need to integrate older adults into responses to the HIV epidemic and to strengthen targeted prevention care and treatment in this population.

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HIV seroprevalence, self-reported STIs and associated risk factors among men who have sex with men: a cross-sectional study in Rwanda, 2015

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053311 ◽

2018 ◽

Vol 95 (1) ◽

pp. 71-74 ◽

Cited By ~ 5

Author(s):

Roman Saba Ntale ◽

Gad Rutayisire ◽

Pierre Mujyarugamba ◽

Eliah Shema ◽

Jane Greatorex ◽

...

Keyword(s):

Cross Sectional Study ◽

High Rate ◽

Risk Behaviours ◽

Sectional Study ◽

Syphilis Infection ◽

Cross Sectional ◽

Logistic Regression Models ◽

The Past ◽

Hiv Test ◽

Sex With Men

ObjectivesIn many populations, men who have sex with men (MSM) are at a high risk of HIV infection. This study aimed to estimate the burden of HIV, other STIs and risk behaviours among Rwandan MSM.MethodsIn this cross-sectional study, we recruited through peer referral men aged between 18 and 60 years, who reported sex with men at least once in the 12 months prior to the survey. Representativeness was increased using ‘seeds’ from a variety of sources. Signed informed consent was obtained from all participants. Data on demographics, risk behaviours and self-reported STIs were collected through an interviewer-administered questionnaire. We screened all eligible participants for HIV using the Rwanda-approved protocol for rapid HIV detection.Results504 MSM were recruited from five major cities in Rwanda. Participants were mostly young (median age 23 years, range 18–55 years) and unmarried (484/504, 96.0%). Thirteen per cent (65/504) of the participants reported past gonorrhoea and/or syphilis infection. Of 504 MSM, 53 (10.5%) reported they were diagnosed and treated for gonorrhoea in the past 12 months and 24 (4.8%) tested positive for HIV. A high proportion (232/504, 46%) reported receiving payment for sex by a man, with almost half of these reporting on more than three occasions (107/232, 46%). Many reported having had an HIV test within the past 12 months (385/504, 76.4%). In multivariate logistic regression models controlling for age, being paid for sex was associated with higher odds of past STI (OR 3.36 (1.82–6.43]; P<0.001) and testing HIV positive (OR 3.13, P<0.05).ConclusionFurther research is needed to understand the high rate of payment for sex in this population, which appears to be a major risk factor for STI including HIV.

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Association between Peer Education and HIV Testing Among Student MSM in China: A Cross-Sectional Study

10.21203/rs.2.22565/v1 ◽

2020 ◽

Author(s):

Changping Li ◽

Xiaomeng Wang ◽

Zhuang Cui ◽

Zeyang Yu ◽

Honglu Zhang ◽

...

Keyword(s):

Hiv Testing ◽

Sexual Behaviors ◽

Peer Education ◽

Cross Sectional Study ◽

Hiv Prevalence ◽

Snowball Sampling ◽

Sectional Study ◽

Cross Sectional ◽

Government Organizations ◽

The Past

Abstract Background HIV prevalence among young men who have sex with men (YMSM) (<25 years old) all over the world varied dramatically from 35.5%(Gambia) to 0.5%(Belgium). In China, by contrast, the HIV prevalence among YMSM was at a low level (5.6%). However, the number of newly diagnosed college students has increased by 30 to 50 percent annually and HIV prevalence among student MSM in China has increased over the past few years, with access to HIV testing and peer education remaining limited. The objective of this study was to examine the relationship between peer education and HIV testing among student MSM in China. Methods The cross-sectional study was conducted in Tianjin, China between January 1, 2018 and December 31,2018. 494 student MSM aged 17-24years old were recruited using snowball sampling. Outcome variables were tested and not tested for HIV in the past year. Besides, social demographics, and sex-related behaviors were collected. Results The prevalence of HIV infection for the population was 5% (25/494). Overall, 60.5% of student MSM had tested for HIV in the past year, among which 68.9% had received peer education service. Peer education was significantly associated with HIV testing. After adjusting for sociodemographic characteristics, sexual behaviors, knowledge about HIV and STD infection, student MSM who received peer education were more likely to test for HIV [OR=19.751; 95%CI: (8.630,45.202)]. Conclusions HIV testing coverage among student MSM in China remains suboptimal. Peer education is significantly associated with HIV testing among this population. Government and non-government organizations could consider this alternatively risk-reduction prevention strategy in the future.

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